Medicare Advantage
What is a Medicare Advantage?
Medicare Advantage, also known as Medicare Part C, is a plan provided by private insurance companies with the help from subsidies provided by the government so that the insurance company can design network based plans at a low or zero premium.
These plans are normally designed with copays and coinsurance throughout the plans as a form of cost share that the client would assume when joining one of these plans. Most plans will include additional benefits at no additional cost to you such as dental, vision, and/or hearing benefits as an example.
So let's take a closer look at Medicare Avantage Plans.
Medicare Advantage Upside:
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It’s convenient to have a single plan for everything
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The plan covers everything traditional Medicare covers (hospital insurance and medical insurance) as well as emergency and urgent care
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Many plans also cover dental care, eyeglasses, and wellness programs
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Most plans also include prescription drug coverage
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Your eligibility isn’t affected by health or financial status
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Most Medicare Advantage plans have zero premiums
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You also have a limited maximum out-of-pocket which can range from $6,800-$11,900 depending on the plan you choose.
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If you have low income, you may qualify for extra help from the State and the Federal Government to pay your copays, deductibles, Part B Medicare Premiums deducted from your Social Security check and many more perks
Medicare Advantage Down Side:
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You’re restricted to certain doctors in your network (unless it’s an emergency) or, you choose a PPO, PFFS, or HMO-POS plan, which allow out-of-network access
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If you decide to switch back to Original Medicare after the first year and purchase a Medicare Supplement Plan, aka a Medigap plan, you could be denied, rated higher cost, and not covered for pre-existing conditions.
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Fact: You can switch back to Original Medicare in the first year you are eligible for Medicare if you initially enrolled in a Medicare Advantage plan.
That statement applies only to Original Medicare, in which case the 20% that Medicare doesn't cover,deductibles and copays can range up to tens of thousands of dollars with no stop-loss unless you purchase a Medigap Policy
Which Medigap Plans Can I Choose From?
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